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Titolo:
CLINICAL-EXPERIENCE IN DEVELOPING TREATMENT REGIMENS WITH THE NOVEL ANTIPSYCHOTIC RISPERIDONE
Autore:
KOPALA LC;
Indirizzi:
QUEEN ELIZABETH II HLTH SCI CTR,SUITE 403,LANE BLDG,1763 ROBIE ST HALIFAX NS B3H 3G2 CANADA
Titolo Testata:
International clinical psychopharmacology
, volume: 12, anno: 1997, supplemento:, 4
pagine: 11 - 18
SICI:
0268-1315(1997)12:<11:CIDTRW>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
D2-DOPAMINE RECEPTOR OCCUPANCY; SCHIZOPHRENIC-PATIENTS; NEUROLEPTIC-NAIVE; CLOZAPINE; MULTICENTER; HALOPERIDOL; SYMPTOMS; SIGNS; DRUGS;
Keywords:
SCHIZOPHRENIA; FIRST-EPISODE PSYCHOSIS; RISPERIDONE; EXTRAPYRAMIDAL SIDE EFFECTS; TREATMENT STRATEGIES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
29
Recensione:
Indirizzi per estratti:
Citazione:
L.C. Kopala, "CLINICAL-EXPERIENCE IN DEVELOPING TREATMENT REGIMENS WITH THE NOVEL ANTIPSYCHOTIC RISPERIDONE", International clinical psychopharmacology, 12, 1997, pp. 11-18

Abstract

Early intervention with antipsychotic-treatment has been shown to reduce the risk of relapse and to improve long-term morbidity in patientswith schizophrenia. However, treatment with conventional neurolepticscarries with it a significant risk of developing extrapyramidal side effects. Conventional neuroleptics exert their antipsychotic effects at doses similar to those that cause extrapyramidal side effects. Although anticholinergic medication (e.g. benztropine) may reduce the severity of these side effects, anticholinergics are themselves associated with significant side effects, such as dry mouth, constipation, blurred vision, urinary retention and sexual dysfunction. Anticholinergic drugs are also associated with impaired cognition and worsening of the patient's psychosis. Newer antipsychotic drugs, such as risperidone, which have a dual mechanism of action (serotonin-dopamine antagonism) are reported to have a lower risk of extrapyramidal side effects than conventional agents. In particular, risperidone produces significant antipsychotic effects at doses lower than those that cause extrapyramidalside effects. Patients presenting with a first episode of psychosis and who are antipsychotic drug-naive may exhibit abnormal movements before treatment is initiated. Unless these patients are carefully assessed at baseline these movements could be mistaken for drug-induced extrapyramidal side effects. It is important to develop treatment strategies for these patients that improve positive and negative psychotic symptoms as quickly as possible, with a minimal risk of extrapyramidal side effects developing. Prompt and appropriate antipsychotic treatment can substantially reduce the risk of relapse. Whereas approximately 60% of unmedicated patients will relapse in the first year following resolution of the acute psychotic episode, prophylactic antipsychotic medication can reduce this rate to less than 20%. Recent clinical experience in Canada has shown that risperidone is effective in the treatmentof patients with first-episode psychosis. Moreover, lower doses of risperidone were required than those previously used to treat chronically ill patients with a history of multiple psychotic episodes and prolonged exposure to conventional neuroleptics. As further data are accumulated, the mean daily dose of risperidone required by first-episode patients has been shown to be close to 4 mg. The low incidence of extrapyramidal side effects in these patients (<10% required anticholinergicmedication) supports the use of risperidone and offers the prospect of improved compliance and a better long-term outcome.

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Documento generato il 01/06/20 alle ore 02:29:58